Keratoconus, (kehr-uh-toh-KOH-nus)

By: B. C. Jensen


As my optomitrist expained to me in, "non doctor talk". How a healthy eye works; A healthy cornea surface is smoothly arched, light is reflected directly to the retna. Light passing from the surface of the cornea is directed to the center of your eye, the retna, that's how you focus and see. You have an eye disease called keratoconus, the good news is, it is not life threatening and I can help you see better with glasses for now and most likely you will have to wear contacts. This is whats happening with your eyes, there are peaks or high points on your cornea. Because of those peaks on what is supposed to be a smooth surface the right amount of light is not reaching your retna, this is why your vision is blurred.
I did some reading about keratoconus and found Duke University eye center and the University of Pittsburgh Medical Center very informative. Defined Keratoconus is a hereditary, degenerative corneal disease that causes a decrease in visual acuity. In patients with keratoconus, the cornea thins and a cone-shaped protrusion occurs in the central portion of the cornea. Management of this disease is aimed at obtaining the best possible vision, and includes the wearing of specialized contact lenses and/or corneal transplant surgery.

Other diseases of the cornea and commonly used terms;

Astigmatism is a condition marked by an irregularity in the curvature of the cornea.
Astigmatic Keratotomy (AK) is a variant of Radial Keratotomy. It is an incision surgical procedure, used to correct astigmatism.
A cataract is a cloudiness or complete opacity of the eye’s natural crystalline lens.
The cornea is the transparent covering over the front of the eye.
Corneal decomposition is a pathologic condition caused by failure of the corneal endothelium to maintain normal fluid content of the storms tissue layer of the cornea, and results in shading and clouding.
Corneal scarring is caused by cornea injury (abrasion, laceration, burns, contact lens injury, or disease).
Dry eye syndrome is a condition in which there is an unusual dryness of the cornea. It is usually due to a deficiency in normal tear production. Dry eye syndrome can result in a sensation similar to that of having a foreign body in the eye, as well as burning and/or redness of the eye. It can also lead to decreased visual acuity.
Fuch’s Dystrophy is a progressive pathologic corneal disorder characterized by a cloudy and swollen cornea, painful epithelial blisters and reduced vision. This condition, which is sometimes hereditary, may require a corneal transplant.
Hyperopia occurs when a refractive error causes blurriness when viewing relatively near objects. It is also known as farsightedness.
Keratoconus is a hereditary, degenerative corneal disease that causes a decrease in visual acuity.
LASIK (laser in-Situ Keratomileusis) is a form of laser treatment for individuals with higher degrees of myopia (greater than 5 diopters).
Myopia is a refractive error. This causes blurriness when viewing objects that are relatively far away. It is also know as nearsightedness.
Ocular cicatricial pemphigold is a chronic disease that may be progressive and may cause blistering and scarring of the eye’s mucous membranes, leading to adhesions between the palpebral bulbar conjunctive.
Penetrating Keratoplasty (Corneal Transplant Surgery) involves replacement of a scarred, diseased or damaged cornea with clear corneal tissue provided from a donor.
Photorefractive Keratectomy (PRK) is a non-invasive procedure that permanently corrects certain errors in vision.
Presbyopia is a condition in which the normal changes in the shape of the lens that occur when looking from a far away object to a near one (or vice-versa) are limited.
Pteryglum is an abnormal wedge-shaped growth on the surface of the conjunctiva.
Radial Keratotomy (RK) is a surgical procedure used to alter the refractive ability of the cornea.
Refraction is the bending of light rays in order to focus them.
A secondary cataract is any cataract that develops from a known cause, such as chronic iritic or drugs (steroids).
Sjogren’s Syndrome is a chronic disease of the body’s connective tissue. Dry eyes, dry mouth, and arthritis characterize it.
http://eye.upmc.com/Keratoconus/

Keratoconus treatment options;
In the early stages of the disease, glasses are often successful in correcting nearsightedness (myopia) and astigmatism; however, as keratoconus advances the cornea is too distorted to benefit from eyeglasses alone. Eventually, rigid contact lenses specially tailored to your individual needs are prescribed to aid in reshaping the corneal surface to provide optimal visual correction. These lenses are tailored to the patient's individual needs and can be costly and time-consuming to fit. The cost of these lenses is submitted to your health insurance carrier.
Surgical options also are available for those patients who can no longer benefit from wearing contact lenses. Intacts are small C-shaped silicone rings that are placed into the cornea to reduce the amount of astigmatism. In some cases, the patient may no longer need contact lenses, or if the patient has been unable to wear contact lenses, he or she may find that wearing lenses is possible again.
Penetrating keratoplasty (corneal transplant) is reserved for patients who can no longer successfully wear contact lenses. In this procedure, the surgeon prepares the keratoconic cornea by removing the central area of the cornea, attaching a full-thickness or partial-thickness corneal graft in its place. If it is required, surgery on the second eye is not performed until the first eye heals. While corneal transplant surgery is one of the most successful forms of organ transplantation, recovery for the patient can be lengthy, requiring the use of antibiotic and immunosuppressive eye drops on a long-term basis to avoid graft complications. Contact lenses are often required after the procedure to achieve visual correction.